微创医学

目的探讨前/后路椎管减压、植骨、内固定术结合术后早期电刺激治疗颈椎外伤伴脊髓损伤的治疗效果。方法对28例颈椎骨折、脱位伤伴脊髓损伤患者行颈前/后路减压、植骨、内固定手术,结合术后早期电刺激治疗。结果 28例患者经随访3个月至4年,植骨均完全愈合,无1例发生钢板螺钉松动、断裂等并发症,脊髓损伤症状改善满意。术前脊髓损伤Frankel分级:A级12例,B级4例,C级5例,D级7例,术后恢复至B级2例,E级26例。按日本骨科学会(JOA)疗效评定标准评分,术后改善率平均77.26%。结论前/后路尽早行椎管减压、植骨、内固定手术结合术后早期电刺激治疗颈椎外伤合并脊髓损伤患者,可预防或减轻脊髓继发性损伤等并发症,提供脊柱有效的固定节段稳定性,促进脊髓功能恢复,取得满意疗效。

Objective To explore the therapeutic effect of the anterior /posterior decompression plus bone graft and internal fixation combined with postoperative early stimulation in the treatment of cervical spine trauma complicated with spinal cord injury treatment． Methods Twenty-eight patients with cervical spine fracture or dislocation associated with spinal cord injury were treated with anterior /posterior decompression plus bone graft and internal fixation operation combined early electrical stimulation after operation．Ｒesults Twenty-eight cases were followed up for 3 months to 4 years． Bone graft healed well，no plate and screw loosening，rupture，or other complication was observed，and symptoms of spinal cord injury improved satisfactorily． Preoperative spinal cord injury Frankel grade was as followed: 12 cases of grade A，4 cases of grade B，5 cases of grade C，7 cases of grade D，and it improved postoperatively to: 2 cases of grade B，26 of cases grade E． According to the Japanese Department of orthopedics Society ( JOA) criteria score， postoperative improvement rate was 77． 26%． Conclusion The treatment strategy of anterior /posterior spinal canal decompression plus bone graft and early internal fixation operation combined with postoperative electrical stimulation can prevent or alleviate the secondary spinal cord injury and other complications，provide effective fixation spinal segmental stability，promote the recovery of spinal cord function，and achieve a satisfactory effect in the treatment of patients with cervical spine injury associated with spinal cord injury．